US7488299B2 - Method and apparatus for physiological testing - Google Patents

Method and apparatus for physiological testing Download PDF

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Publication number
US7488299B2
US7488299B2 US11/349,532 US34953206A US7488299B2 US 7488299 B2 US7488299 B2 US 7488299B2 US 34953206 A US34953206 A US 34953206A US 7488299 B2 US7488299 B2 US 7488299B2
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United States
Prior art keywords
resistance
movement
movable member
shaft
measuring
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Expired - Fee Related
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US11/349,532
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US20060173384A1 (en
Inventor
Richard Creswick
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Tek Solutions Pty Ltd
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Tek Solutions Pty Ltd
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Assigned to TEK SOLUTIONS PTY LTD reassignment TEK SOLUTIONS PTY LTD ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CRESWICK, RICHARD
Publication of US20060173384A1 publication Critical patent/US20060173384A1/en
Priority to US12/347,596 priority Critical patent/US7955277B2/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
    • A61B5/224—Measuring muscular strength
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/16—Devices for psychotechnics; Testing reaction times ; Devices for evaluating the psychological state
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
    • A61B2505/09—Rehabilitation or training
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6824—Arm or wrist

Definitions

  • This invention relates to a method and apparatus for measuring the performance of human joints.
  • the present invention is concerned with measuring the performance of a joint or combination of such in the human body and, in particular, to measuring the effort exerted by a patient during the performance testing process.
  • the extent of the injured person's injuries When persons suffer injuries in accidents such as those which commonly occur in the workplace, and in road traffic accidents, it is usually necessary for the extent of the injured person's injuries to be determined in order to assess the correct amount of compensation which may be payable to the injured person as a result of the accident.
  • the compensation payable will be related to the extent of the person's injuries and the loss of use or performance of parts of the person's body due to the accident. For example, if a person injures their arm in an accident the compensation payable will depend on the extent to which that person's use of their arm has been impaired. Further, an accurate assessment of an injury allows a rehabilitation programme to be monitored and varied if necessary.
  • a further related problem arises, in that since it is not possible to accurately measure joint performance, it is not possible to accurately measure improvement in joint performance. Thus if a patient is undergoing physiotherapy or other treatment for injuries associated with a joint it is not, for example, possible to accurately plot improvement or lack of fit in the joint on a week by week basis.
  • the present invention aims to provide a device for repeatedly and accurately measuring the performance of a joint in the body and which preferably includes means for determining whether the patient whose joint performance is being measured is making a minimal or at least sub-maximal effort, when tested.
  • the present invention provides a device for performance testing of a human's joints comprising:
  • a resistance means for varying the resistance to movement of the moveable member at least once during a single movement of the moveable member by the human
  • the moveable member may be a shaft or a lever.
  • the movable member may be a piston in a hydraulic cylinder.
  • Mechanisms such as chains or belt and sprocket drives, may be connected to the movable member to convert rotational or linear movement of the member to other types of movement.
  • a cable/capstan and angle sensing device could be used for handling linear/compound movement.
  • the shaft may be rotatable.
  • the sensor may comprise a torque sensor for measuring torque applied to the shaft.
  • the movable member is a piston of a hydraulic cylinder
  • the sensor may comprise a pressure sensor measuring the fluid pressure inside the cylinder.
  • An adjustable control valve controlling the exit of fluid from the cylinder.
  • Two or more cylinders acting together could be used.
  • the resistance means may comprise a coupling means that variably couples the shaft to the torque sensor.
  • a coupling means that variably couples the shaft to the torque sensor.
  • Such variable coupling of shaft and torque sensor varies the resistance to the turning of the shaft.
  • An example of such a resistance means is an electric brake, eddy coupling, servo motor or the like.
  • the resistance means comprises a coupling means
  • the resistance is variable between a state where there is no coupling and no resistance is applied and the shaft is free to rotate relative to the torque sensor and a state in which the shaft is fully coupled to the torque sensor.
  • the device includes an encoder for measuring the position of the shaft.
  • the device may also include a control means for receiving input data from the torque sensor.
  • the control means may also be arranged to input control signals to the resistance means and to determine the relationship between the resistance applied to the shaft and the torque measured by the torque sensor. Further, the control means may receive signals from the encoder in relation to the angular position of the shaft.
  • the moveable member comprises a lever
  • said lever may be connected to a resistance means.
  • the resistance means may comprise a pump member.
  • the pump member typically has a control valve to vary resistance to the lever.
  • the pump member of this embodiment may be connected to a sensor, said sensor measuring the force applied to the lever.
  • the sensor may comprise a pressure gauge to measure the pressure change of fluid in the pump as force is applied to the lever.
  • a number of devices may be operated together simultaneously to deal with movement in multiple axes.
  • the present invention provides a method of sincerity of effort testing of a person's joint performance by repeatedly measuring the response of that joint to a varying load.
  • the present invention provides a method of measuring a person's joint performance and simultaneously measuring sincerity of effort by
  • the invention provides a method of sincerity of effort testing of a person's joint performance by measuring the torque applied to a shaft by one of the person's joints comprising the steps of:
  • FIG. 1 is a schematic drawing of a device for repeated performance measuring to gauge sincerity of effort
  • FIGS. 2 and 3 are graphs comparing the resistive load applied to the device against measured torque.
  • FIG. 4 is a schematic drawing of a second embodiment of a device for testing sincerity of effort.
  • the device generally indicated at 10 , includes a rectangular box-like casing 12 .
  • One side of a torque sensor 14 is mounted to one interior wall 15 of the casing.
  • Fixed to the opposite side of the torque sensor 14 is a mounting plate 16 defining a central hole 18 through which one end of an elongate shaft 20 extends.
  • the end of the shaft 20 is free to rotate relative to the mounting plate and the torque sensor 14 .
  • the shaft 20 extends from the mounting plate 16 co-axial with the torque sensor 14 and defines a free end 21 which projects through an aperture 22 defined in a wall 24 of the casing opposite to the wall 15 to which the torque sensor 14 is mounted.
  • the free end 21 of the shaft 20 defines a coupling 26 which can be attached to various joint testing interfaces for testing any joints or combinations of such which can be used to produce rotary motion about an axis, which most if not all joints are capable of.
  • a brake stator coil 28 defining a central bore 30 which is of greater diameter than the shaft is fixed to the mounting plate 16 .
  • the shaft 20 extends through that central bore 30 .
  • a brake rotor 32 is mounted on the shaft 20 and defines a friction surface 34 facing the brake stator coil 28 and in conjunction with the brake stator coil 28 defines an electric brake.
  • Increasing the current supplied to the brake rotor 32 increases the resistance between the brake rotor 32 and the brake stator coil 28 and hence the coupling between the two.
  • the shaft 20 spins freely and no torque is applied to torque sensor 14 .
  • a shaft encoder 36 mounted on the wall 24 of the casing measures the angular position of the shaft 20 .
  • a computer control means in the form of a micro controller 50 is connected to the torque sensor 14 and the shaft encoder 36 and receives input signals indicative of the torque measured by the torque sensor and the angular position of the shaft as measured by the shaft encoder.
  • the micro controller also controls the current applied to the electric brake via a feedback loop.
  • the device 10 works by using the brake rotor 32 and brake stator coil 28 to provide increasing resistance to the turning of the shaft 20 about its longitudinal axis which is measured by the torque sensor 14 .
  • the resistance can be quickly and accurately controlled by varying the current applied to the brake rotor 32 .
  • the torque applied to the shaft 20 is measured by the torque sensor 14 and this therefore gives a measurement of the performance of a patient's joint or combination.
  • the computer control means 50 is programmed to vary the resistive load provided by the electric brake, whilst the shaft 20 is being turned by the patient. This makes it much more difficult for a patient to misrepresent the test since whilst it is relatively straightforward to decide to make a “50% effort, say, when moving against an unchanging resistance, when the resistance changes continuously, the patient is unable to accurately and quickly calculate the changing level of effort they need to apply to be consistent with their original level of effort.
  • the system thus varies the resistive load applied to the electric brake, changing the resistance to turning of the shaft by the patient.
  • the device 10 measures the torque applied to the shaft 20 by the patient and correlates the measured torque with the resistance applied to the turning of the shaft 20 .
  • the device 10 rapidly varies the resistance to the turning of the shaft 20 during a single exercise performed by the patient. Thus, if the patient is asked to, say, pull his/her fist up to his shoulder, in that one movement, the resistance to the turning of the shaft would vary several times.
  • FIGS. 2 and 3 are of a step change nature.
  • the relationship L between the measured torque 52 and the resistance applied 54 is shown to be fairly constant. If however, a patient is attempting to cheat the test by making only a “50% effort”, then they will not be able to maintain that sub-maximal 50% effort consistently as the load is varied and a greater variation/standard deviation in the relationship L of the measured torque and the resistive force will be measured, as shown in FIG. 3 . The tests may also be repeated, with variations in the patient's performance further indicating sub-maximal effort.
  • the variation of the resistive load may be based on position of the shaft as measured by either the encoder or time.
  • the variation may be continuously varied for example by a ramped load or a stepped load or both.
  • the variation may be increasing or decreasing or consistent stopping.
  • the electric brake may be replaced by an equivalent element such as an eddy current coupling or similar controlled coupling device or servomotor.
  • the method of providing a variable resistance could be a hydraulic motor or actuator with a variable flow control so that the oil flow could be restricted to provide a controlled resistive torque.
  • the system may be active or passive.
  • the resistive electric brake could be replaced by a variable torque servo drive.
  • the device provides a repeatable way of measuring joint performance, it is possible to measure improvement in joint performance, for example, the performance of an elbow could be measured on a weekly basis and increases in the strength and range of movement of the joint performance measured and tracked.
  • Correlation ⁇ ⁇ Coefficient Cov ⁇ ( X , Y ) StdDevX ) ⁇ ( StdDevY )
  • Cov ( X, Y ) 1 /n ⁇ ( x i ⁇ x )( y i ⁇ y )
  • y and x are the values of the force applied by the patient and the applied resistance, respectively.
  • a correlation coefficient of +1.0 is a strong positive result. As x goes up, y always goes up. A correlation of +0.5 is a weak positive, with y tending to go up as x does. A correlation coefficient of 0 shows no correlation, with 0.5 being weak negative and ⁇ 1.0 being a strong negative.
  • a positive number close to 1 indicates a high degree of correlation and strongly suggests sincerity of effort.
  • FIG. 4 illustrates a further embodiment of a device for performance testing of joints.
  • the movable member in this embodiment is a piston 102 slideable within a cylinder 104 containing hydraulic fluid. Forces F acting to push the piston into the cylinder cause the pressure in the hydraulic cylinder to increase and the discharge of hydraulic fluid through an exit pipe 106 .
  • An electrically operable adjustable control valve 108 controls the ease of flow through the exit pipe by varying its degree of closure. Expelled hydraulic fluid may pass into a reservoir 110 .
  • a pressure sensor 112 in the hydraulic cylinder measures the pressure therein which depends on the force F applied to the piston.
  • the sensors measurements are sent to a computer control means 120 which also controls the valve 108 .
  • the degree of resistance to movement of the piston may be varied by the control valve 108 .
  • the correlation between the force applied and the resistance to movement can be calculated by a computer control means 120 which controls the degree of opening of the valve and receives and input from the pressure sensor 112 measuring the hydraulic pressure in the cylinder.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Physiology (AREA)
  • Rheumatology (AREA)
  • Developmental Disabilities (AREA)
  • Psychiatry (AREA)
  • Psychology (AREA)
  • Social Psychology (AREA)
  • Hospice & Palliative Care (AREA)
  • Educational Technology (AREA)
  • Child & Adolescent Psychology (AREA)
  • Force Measurement Appropriate To Specific Purposes (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
US11/349,532 2003-08-07 2006-02-06 Method and apparatus for physiological testing Expired - Fee Related US7488299B2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US12/347,596 US7955277B2 (en) 2003-08-07 2008-12-31 Method and apparatus for physiological testing

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
AU2003904214A AU2003904214A0 (en) 2003-08-07 2003-08-07 Method and apparatus for physiological testing
AU2003904214 2003-08-07
PCT/AU2004/001038 WO2005013821A1 (en) 2003-08-07 2004-08-05 Method and apparatus for physiological testing

Related Parent Applications (1)

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PCT/AU2004/001038 Continuation-In-Part WO2005013821A1 (en) 2003-08-07 2004-08-05 Method and apparatus for physiological testing

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US12/347,596 Continuation-In-Part US7955277B2 (en) 2003-08-07 2008-12-31 Method and apparatus for physiological testing

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US20060173384A1 US20060173384A1 (en) 2006-08-03
US7488299B2 true US7488299B2 (en) 2009-02-10

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US (1) US7488299B2 (enExample)
EP (1) EP1651108A4 (enExample)
JP (1) JP4631849B2 (enExample)
AU (1) AU2003904214A0 (enExample)
CA (1) CA2534366C (enExample)
NZ (1) NZ545207A (enExample)
WO (1) WO2005013821A1 (enExample)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090149780A1 (en) * 2003-08-07 2009-06-11 Richard Creswick Method and Apparatus for Physiological Testing

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109893145A (zh) * 2017-12-08 2019-06-18 深圳市第二人民医院 大鼠肩关节的扭矩测试装置

Citations (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3501142A (en) * 1967-12-04 1970-03-17 Monark Crescent Ab Bicycle exerciser with cyclically varying resistance
US4037480A (en) 1972-10-07 1977-07-26 Max-Planck-Gesellschaft Zur Forderung Der Wissenschaften E.V. Manual dexterity aptitude testing
US4765613A (en) 1987-01-22 1988-08-23 Paramount Fitness Equipment Corporation Progressive resistance exercise device
US4884445A (en) 1988-11-28 1989-12-05 Armin M. Sadoff Grip strength analyzer apparatus and method of using same
US4934692A (en) * 1986-04-29 1990-06-19 Robert M. Greening, Jr. Exercise apparatus providing resistance variable during operation
US5078152A (en) 1985-06-23 1992-01-07 Loredan Biomedical, Inc. Method for diagnosis and/or training of proprioceptor feedback capabilities in a muscle and joint system of a human patient
US5114389A (en) * 1989-06-23 1992-05-19 Brentham Jerry D Stair climber exercise device
US5158095A (en) 1991-06-07 1992-10-27 N. K. Biotechnical Engineering Company Machine and method for testing exerted effort without patient malingering effects
US5174154A (en) 1990-09-12 1992-12-29 Greenleaf Medical Systems, Inc. Isometric force measuring device
US5184628A (en) 1990-04-06 1993-02-09 Shah Khalid M Grip sincerity assessment system and method
US5348519A (en) 1988-02-04 1994-09-20 Loredan Biomedical, Inc. Exercise and diagnostic apparatus and method
US5419562A (en) * 1993-08-10 1995-05-30 Cromarty; John I. Method and apparatus for analyzing movements of an individual
US5722937A (en) 1994-03-30 1998-03-03 Cybex International, Inc. Exercise physical rehabilitation and testing method and apparatus with cycloidal reducer
US6086517A (en) * 1999-07-26 2000-07-11 Schapmire; Darrell William Apparatus and method for testing pushing and pulling capacity and exercising a muscle

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US5142910A (en) * 1990-06-27 1992-09-01 Occupational Orthopaedic Systems, Inc. Dynamic physiological function testing apparatus and method
US5597373A (en) * 1991-11-08 1997-01-28 Cedaron Medical, Inc. Physiological evaluation and exercise system
JP2787189B2 (ja) * 1994-04-22 1998-08-13 学校法人桐蔭学園 関節拘縮用測定及び治療装置
JP2003116822A (ja) * 2001-06-26 2003-04-22 Matsushita Electric Works Ltd 筋活動解析装置およびトレーニング装置

Patent Citations (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3501142A (en) * 1967-12-04 1970-03-17 Monark Crescent Ab Bicycle exerciser with cyclically varying resistance
US4037480A (en) 1972-10-07 1977-07-26 Max-Planck-Gesellschaft Zur Forderung Der Wissenschaften E.V. Manual dexterity aptitude testing
US5078152A (en) 1985-06-23 1992-01-07 Loredan Biomedical, Inc. Method for diagnosis and/or training of proprioceptor feedback capabilities in a muscle and joint system of a human patient
US4934692A (en) * 1986-04-29 1990-06-19 Robert M. Greening, Jr. Exercise apparatus providing resistance variable during operation
US4765613A (en) 1987-01-22 1988-08-23 Paramount Fitness Equipment Corporation Progressive resistance exercise device
US5348519A (en) 1988-02-04 1994-09-20 Loredan Biomedical, Inc. Exercise and diagnostic apparatus and method
US4884445A (en) 1988-11-28 1989-12-05 Armin M. Sadoff Grip strength analyzer apparatus and method of using same
US5114389A (en) * 1989-06-23 1992-05-19 Brentham Jerry D Stair climber exercise device
US5184628A (en) 1990-04-06 1993-02-09 Shah Khalid M Grip sincerity assessment system and method
US5174154A (en) 1990-09-12 1992-12-29 Greenleaf Medical Systems, Inc. Isometric force measuring device
US5158095A (en) 1991-06-07 1992-10-27 N. K. Biotechnical Engineering Company Machine and method for testing exerted effort without patient malingering effects
US5419562A (en) * 1993-08-10 1995-05-30 Cromarty; John I. Method and apparatus for analyzing movements of an individual
US5722937A (en) 1994-03-30 1998-03-03 Cybex International, Inc. Exercise physical rehabilitation and testing method and apparatus with cycloidal reducer
US6086517A (en) * 1999-07-26 2000-07-11 Schapmire; Darrell William Apparatus and method for testing pushing and pulling capacity and exercising a muscle

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* Cited by examiner, † Cited by third party
Title
Lechner, et al., "Detecting Sincerity of Effort: A Summary of Methods and Approaches," (1998) Physical Therapy 78(8):867-888.

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090149780A1 (en) * 2003-08-07 2009-06-11 Richard Creswick Method and Apparatus for Physiological Testing
US7955277B2 (en) 2003-08-07 2011-06-07 Tek Solutions Pty Ltd Method and apparatus for physiological testing

Also Published As

Publication number Publication date
CA2534366C (en) 2012-10-09
JP4631849B2 (ja) 2011-02-16
EP1651108A4 (en) 2009-05-27
NZ545207A (en) 2007-11-30
CA2534366A1 (en) 2005-02-17
EP1651108A1 (en) 2006-05-03
WO2005013821A1 (en) 2005-02-17
AU2003904214A0 (en) 2003-08-21
JP2007501640A (ja) 2007-02-01
US20060173384A1 (en) 2006-08-03

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